Antibiotics for the Critically Ill Patient
We spend a lot of time obsessing over the finer details of critical care: which fluid is best? which vasopressor is best? will another liter of fluid help? These details are important, but for a septic patient something... read more
Sepsis Incidence and Mortality are Underestimated in Australian ICU Administrative Data
When compared with the reference standard — prospective clinical diagnosis — ANZICS CORE database criteria significantly underestimate the incidence of sepsis and overestimate the incidence of septic shock, and also result... read more
Benzodiazepine Use and Neuropsychiatric Outcomes in the ICU
The majority of included studies indicated that benzodiazepine use in the ICU is associated with delirium, symptoms of posttraumatic stress disorder, anxiety, depression, and cognitive dysfunction. Future well-designed studies... read more
Overuse of troponin? A comprehensive evaluation of testing in a large hospital system
Troponin assays are integral to the diagnosis of acute myocardial infarction (AMI), but there is concern that testing is over utilized and may not conform to published guidelines. We reviewed all testing performed at 14 hospitals... read more
Blue Collar, Blue Scrubs: The Making of a Surgeon
Blue Collar, Blue Scrubs turns back the clock, taking readers from his days as a construction worker to his entry into medical school, expertly infusing his journey to become a doctor with humanity, compassion, and humor.... read more
Effect of Thiamine Administration on Lactate Clearance and Mortality in Patients With Septic Shock
Thiamine administration within 24 hours of admission in patients presenting with septic shock was associated with improved lactate clearance and a reduction in 28-day mortality compared with matched controls. Patients who... read more
Procedure Eases Complications Related to Fluid Around Lungs
As people live longer with more advanced stages of cancer or chronic diseases, the longer their complications must be treated. That can include pleural effusions, an unusually large amount of fluid around a person’s lungs... read more
Corticosteroid Treatment in Critically Ill Patients with Severe Influenza Pneumonia
Administration of corticosteroids in patients with severe influenza pneumonia is associated with increased ICU mortality, and these agents should not be used as co‑adjuvant therapy. A total of 1846 patients with primary... read more
Peripheral Vasopressors: The Myth and the Evidence
You are working in a small, rural hospital staffed by one physician and one nurse. There are multiple sick patients, all of whom require your attention, but the sickest is probably the 62 year old female with pneumonia and... read more
Early Lactate Measurements Appear to Improve Results for Septic Patients
The study by Churpek and colleagues was designed to evaluate both the frequency of urgent lactate measurements and their association with clinician interventions and mortality. An elevated lactate level means that a patient's... read more
Machine Learning Can Reduce Tests, Improve Treatments for ICU Patients
Researchers from Princeton University are using machine learning to design a system that could reduce the frequency of tests and improve the timing of critical treatments for ICU patients. To create the system, the researchers... read more
Adherence of Newborn-Specific Antibiotic Stewardship Programs to CDC Recommendations
Significant gaps exist between CDC recommendations to improve antibiotic use and antibiotic practices during the newborn period. There is wide variation in point prevalence AURs. Three-quarters of infants who received antibiotics... read more
Effectiveness of Influenza Vaccination on Hospitalizations and Risk Factors for Severe Outcomes in Hospitalized Patients With COPD
Influenza vaccination significantly reduced influenza-related hospitalization among patients with Chronic Obstructive Pulmonary Disease (COPD). Initiatives to increase vaccination uptake and early use of antiviral agents... read more
Assessment of the Safety of Discharging Select Patients Directly Home From the ICU
The discharge of select adult patients directly home from the ICU is common, and it is not associated with increased health care utilization or increased mortality. Among the 6732 patients included in the study, 2826 (42%)... read more
Testing Epinephrine for Out-of-Hospital Cardiac Arrest
Despite having a powerful effect on restoring spontaneous circulation after out-of-hospital cardiac arrest, epinephrine produced only a small absolute increase in survival with no increase in favorable functional recovery... read more
Vasodilatory Shock in the ICU and the Role of Angiotensin II
With the approval and release of angiotensin II, a new vasoactive agent is now available to utilize in these patients. Overall, the treatment for vasodilatory shock should not be a one-size fits all approach and should be... read more
Predicting Mortality in Patients Undergoing VA-ECMO After CABG
Prediction scoring systems for coronary artery bypass grafting (CABG) patients on venoarterial extracorporeal membrane oxygenation (VA-ECMO) have not yet been reported. This study was designed to develop a predictive score... read more
Adherence to Guidelines for the Management of Donors After Brain Death
Guideline adherence to an expert panel predefined care set in brain death (DBD) donor management proved moderate leaving substantial room for improvement. An importance-performance analysis can be used to improve implementation... read more
Artificial Intelligence in the ICU
ICU doctors are often required to analyse large volumes of complex, heterogeneous data to make life-critical decisions. Artificial Intelligence (AI), if used effectively, could reduce this burden by transforming data into... read more
Many Doctors Have Distorted Perceptions of the Value of Medical Tests
In 2014, the Canadian Task Force on Preventive Health Care recommended against the prostate-specific antigen (PSA) test used to screen for prostate cancer in healthy men, concluding that it results in substantial harms via... read more
A New ICU Equipment Diagram… But is it Art?
It is well established that the Arts have a clear contribution to make in the delivery of an improved healthcare experience for patients, service users and staff. Southmead Hospital (part of North Bristol NHS Trust) has a... read more
Shock: Roadside to Resus
If you're involved in the care of critically unwell patients then you will frequently encounter patients who are shocked. The European Society of Intensive Care Medicine defines shock as; "Life-threatening, generalized... read more
